Abstract
Introduction: Patients with mitral stenosis with severe pulmonary artery hypertension (PAH) constitute a high-risk subset for surgical commissurotomy or valve replacement. Objectives: to examine the effect of PAH on immediate and long term results of the percutaneous mitral commissurotomy (PMC) in 480 patients. Methods: The immediate procedural and the long-term clinical outcome after first-time PMC of 225 patients with systolic pulmonary artery pressure >1⁄445 mmhg (group 1) were retrospectively collected and compared with those of 255 patients with systolic pulmonary artery pressure 8, and atrial fibrillation. The two groups were similar in terms of the final mitral valve area, the gain of mitral valve area, the mean pressure gradient across the mitral valve, and the complication rate (NS for all). The procedural success was similar (p 1⁄4 NS). The residual systolic pulmonary artery pressure was higher in group 1 (42.9+/-14mmhg VS 31.8+/-12 mmhg, p<0.01). During a mean follow-up of 79+/-51months, there was no difference in the overall survival rate, but restenosis rate and cardiac events was higher in group 1 (p<0.05). Conclusion: PMC is safe and effective, has a low morbidity and mortality rate, but has poorer long-term outcome in patients with PAH. Disclosure of Interest: None Declared
Published Version
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